When I was a kid there was a TV Show on ABC about an older “family” Doctor and his young partner. Even as a young teenager I was fascinated with the content of the show (they addressed some very controversial medical /social issues of the time) and how they portrayed the ideal clinical setting where your “family” Doctor knew you, and your family members by name and provided personalized care all the way through your illness journey -including post care (every TV episode had a happy ending where Dr. Welby and the patient continued their personal relationship). The show depicted office visits that were much longer than the current average of 16.7 minutes and average patient loads of 2,500 patients per physician. Today it’s estimated that a Primary Care doctor would need to work 21.7 hours a day to address all of the acute, chronic, and preventive care needs of a practice of 2,500 patients.
Under the current perverse fee-for-service method of paying doctors and the fact that most physician practices are owned by some other entity other than the physician there is more and more pressure on them to see more patients and spend less time to know and understand them. It’s an assembly line of providing a primary diagnosis then shipping the patient off to a specialist and probably a surgery or procedure that promotes overuse of imaging and hospital stays. I’m reminded of an incident a couple of years ago when I was at a check-up with my own Primary Care Doctor (part of a large bureaucratic health system). She asked at the end of the visit if I had any other concerns. I told her that I had a skin tag in my armpit and asked if she would freeze it and clip it off. Her immediate answer was “no, you’ll have to go see one of our dermatologists for that”. She never even examined it. She probably didn’t have time because she had a couple of dozen more patients to see that day.
The problem with all of this is you as the employer are paying for the assembly line health system which has proven to be wasteful and ineffective. You pay more than you should, and your employees and their families do not get the personal attention and quality care they deserve. This “system” I speak of is intentional and is stacked against you. But there are alternatives you can employ to reduce your employee health spend and provide BETTER access to care for your employees. It’s called Direct Primary Care.
Direct Primary Care is the response of doctors who want to be independent and practice Marcus Welby – type medicine without the pressure to create more revenue for some big health system by seeing too many patients per day and being judged by how many referrals they send through the health system assembly line. They actually want to build a relationship with their patients and provide all the appropriate care they can within their own clinical setting. That includes some prescription drugs for chronic conditions. They limit their practice size so they can spend more time with each patient before pushing them out the door or automatically sending them down the health system assembly line. Their payment model is fair and transparent. They charge a monthly fee per patient that includes all of their services regardless of how many times they see a patient that month. They refuse to work with insurance companies because of their bureaucracy and hidden profit margins. They instead contract with employers directly to care for their employees and families. As an employer your medical costs will decrease if only because it removes the middleman as a third party that provides no real health benefit and only siphons off profit in the process. And some Direct Primary practices take on the role of medical management for your health plan. Who could possibly be better as a care coordinator for your employees while also acting as a steward of your health care dollars?
I have yet come across an employer or patient who has had a negative experience with Direct Primary Care. In fact, the opposite. I can’t find an employer or patient who hasn’t been amazed with the difference of care and cost compared to the fee-for-service system that is more focused on generating revenue than personalized patient care. You owe it to yourself and your employees to explore Direct Primary Care for your health plan. They deserve to get care like Marcus Welby, MD provided. I can help you start that journey. Give me a call at (815) 742-2077 or contact me by clicking below.